And so we enter Week Three of Phase Three, and once again I don’t have much to report. The withdrawal symptoms have been mild: some obsessive thoughts, a lingering tiredness, but not much else. In his book entitled The Antidepressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction” Joseph Glenmullen lists six criteria for determining if a person’s ready to start tapering off antidepressants. They are:
- The patient’s original condition has improved substantially.
- The patient is in a relatively stable, calm period in life.
- The patient has grown, or changed, psychologically in ways that make her less vulnerable to the condition the drug was used to treat.
- The patient’s life circumstances have changed so significantly that the circumstances originally making him depressed, anxious, or otherwise symptomatic are no longer present.
- The patient has significant side effects that contribute to the desire to go off the medication or that necessitate going off.
- The patient wants to go off the antidepressant rather than stay on it indefinitely because of concerns about long-term, largely unknown, side effects and risks, especially if she no longer needs the drug.
I meet at least five, if not all six of those criteria:
My OCD has improved substantially, especially since I went after my biggest fear and especially since making the conscious choice to stop caring so damn much about the disorder in the first place. (At the risk of belabouring the point, Dr. Steve Phillipson’s article about choice is an invaluable resource.)
I’m in as stable and calm a period in life as I have been in ages. I can’t stress this enough: my new, more relaxed travel schedule has had an incredibly positive effect on my mental health. Meanwhile, having Sam in the same house instead of being on opposite ends of the world’s second-biggest country has had a bigger impact than any antidepressant.
I’ve grown psychologically in ways that make me less vulnerable to the condition the drug was used to treat. Antidepressants certainly helped, but Exposure with Response Prevention – ERP – is what really got me where I am and what’ll keep me there long-term. By January, when the Great Trintellix Taper of 2018 started, antidepressants had become almost redundant: I didn’t need them to keep my anxiety in check because ERP was doing that already. And while antidepressants quiet my obsessive thoughts it’s at the expense of my vitality. I’m no longer willing to make that trade (and besides, ERP quiets them as well by rewiring the brain’s circuitry).
My life circumstances have changed so significantly that the circumstances originally making him symptomatic are no longer present. This one’s tougher to quantify since OCD’s a chronic condition. Again, though, moving back to Toronto and travelling far less frequently have had a sizeable impact.
I have significant side effects that contribute to the desire to go off the medication or that necessitate going off. Among other things, I’ve had a lot more energy since I started tapering – despite the current lethargy. And my mood’s been great.
I want to go off the antidepressant rather than stay on it indefinitely because of concerns about long-term, largely unknown, side effects and risks, especially if she no longer needs the drug. Firstly, and like I’ve said before, I feel as though anyone would rather take less medication if given the option (although I’m told that’s not the case – which baffles me, but there you go). Secondly, in general I’m worried about long-term side effects, yeah.
I guess that makes me six-for-six.
Roll on, June 20. And roll on to when I can start blogging about the Minnesota Vikings and Pearl Jam concerts (August 18 and 20 at Wrigley, baby!) and Hamilton instead of antidepressant withdrawal symptoms. I love having this platform for sharing my journey, but there’s a lot more I’d rather be writing about. We’ll be one step closer in six weeks.